“…Recent advances have demonstrated that CYP3A4 cooperativity involves the binding of multiple (at least 2) substrate molecules to the binding pocket and represents a case of true allostery characterized by effector-induced conformational transitions (Davydov and Halpert, 2008). On the basis of the above theory and our results, the differential effects of PXT on the metabolism of MDZ, similar to the effectors of citral, 6-gingerol, and D-limonene (Zhang and Lim, 2008), can be explained by a two-site model (Korzekwa et al, 1998;Domanski et al, 2001) or a multi-site model (Kenworthy et al, 2001;Manoj et al, 2010;Smirnov et al, 2011) of CYP3A4. It can be hypothesized that PXT can bind to one defined site that is also occupied by MDZ in the position required for 4-hydroxylation (or 19-hydroxylation) and that both substrates can displace each other.…”